General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsSorry, We Don’t Take Obamacare
Anyone who is on these plans knows its a two-tiered system, said Ms. Moses, describing the emotional sting of those words to a successful entrepreneur.
Anytime one of us needs a doctor, she continued, we send out an alert: Does anyone have anyone on an exchange plan that does mammography or colonoscopy? Who takes our insurance? Its really a problem.
The goal of the Affordable Care Act, which took effect in 2013, was to provide insurance to tens of millions of uninsured or under-insured Americans, through online state and federal marketplaces offering an array of policies. By many measures, the law has been a success: The number of uninsured Americans has dropped by about half, with 20 million more people gaining coverage. It has also created a host of new policies for self-employed people like Ms. Moses, who previously had insurance but whose old plans were no longer offered.
http://www.nytimes.com/2016/05/15/sunday-review/sorry-we-dont-take-obamacare.html?_r=0
Kittycat
(10,493 posts)Nor does it make it affordable.
valerief
(53,235 posts)for medical care by doctors and for medicine. It doesn't pay for health. I wish we could call it what it is.
tularetom
(23,664 posts)It ought to be called "Obamasurance".
What a joke it turned out to be.
valerief
(53,235 posts)I have mixed feelings about the ACA. I wouldn't have medical insurance without it, but, yes, affordable is misleading, especially with all the high deductibles and co-pays. I wish we were like the civilized countries that provide taxpayer-paid medical care. We get 7 wars instead.
Jackie Wilson Said
(4,176 posts)xocet
(3,871 posts)Any ideas?
sweetapogee
(1,168 posts)to work a few kinks out of the system, no biggie.
Mika
(17,751 posts)The entire insurance and health system are mandated not for profit.
enlightenment
(8,830 posts)in terms of cost and coverage.
There is a world of difference between those systems and the joke that is US healthcare.
If insurance companies and hospitals were not allowed to make a profit that would fix so many things.
Make enough money to pay employees a livable wage, buy h/w etc. , but no share holders
Hoyt
(54,770 posts)Today, with the ACA loss-ratio, the profit part is around 7% of the premium. Nix that, and you'd still have hefty premiums.
We need to solve this problem, but it is much deeper than the insurance companies. In fact, until the structural problem is solved -- as well as patient expectations -- that 7% is not much considering the risk insurance companies are taking in this environment.
fasttense
(17,301 posts)Money was suppose to be set aside for grants for healthcare co-ops. But RepubliCONS managed to turn them into loans instead and it ensured most of them went belly up.
There is no reason for healthcare CEOs to be making hundreds of millions of dollars. For profit healthcare is exploitive and dangerous.
Hoyt
(54,770 posts)I agree on CEO salaries. But, if you paid them only a dollar an hour, it wouldn't make 2 cents difference in peoples' premiums.
Silver_Witch
(1,820 posts)ViseGrip
(3,133 posts)we have to use. Thank you for the 11 billion added to the ACA, Hillary tried to say you had nothing to do with. My county just built three more of these 'centers'. Now I have 11 clinics I can go to, with or without an appt.! Again, thank you Bernie, while doctors are not complying.
They cannot handle another set of paperwork! That is why!
DOCTORS ARE BEGGING FOR A SINGLE PAYER SYSTEM. THEN THEY CAN ACCEPT YOU. Now....too much different paperwork, rules from all private ins. co. They can handle Medicare. I have had these conversations with doctors over the years, even before the ACA, they could not handle the patient load, and paperwork. The ACA is a whole new set of paperwork for them. They just can't handle it.
Check out Physicians for a National Health Program
www.pnhp.org
savalez
(3,517 posts)to visit a Community Health Center?
truebluegreen
(9,033 posts)http://www.nachc.com/healthreform.cfm
From TPM http://talkingpointsmemo.com/dc/sanders-role-in-the-affordable-care-act
Sanders advocacy of the community health centers is well-documented. The $11 billion the centers ultimately received were among his conditions for his vote on the final bill, which hinged on every Democratic senators support to pass since Republicans had eventually all come out against the legislation.
<snip>
Having lost the battles on the public option and single-payer, Sanders put his full weight behind the community health centers provision.
He said to Harry Reid, Im not going to vote for this bill unless I get a gargantuan sum of money for community health centers, McDonough told TPM.
savalez
(3,517 posts)Last edited Sun May 15, 2016, 03:18 PM - Edit history (1)
I'm not familiar with Florida's health care system, just Vermont's. No need to be snarky with the "learn something" by the way.
Thank goodness the Dems passed the ACA or those centers you relied on would not have existed. Expanded medicare is also in the ACA but I understand you have a RW governor who declined it. I'm sure you're working hard to vote him out.
truebluegreen
(9,033 posts)Maybe he or she was put off by your snarkiness. My snarkiness was in response to your apparent assumption that Bernie has only done things in Vermont. Thank goodness, as you put it, that he insisted on the ACA containing the aforementioned health clinics, and funding them well.
IronLionZion
(45,457 posts)to the plan and it is awesome that Bernie got it included. The independent family doctor shortage started long before the PPACA and America has been trending that way for some time. The AMA isn't helping and they are still enforcing limits to Med school enrollments without any exceptions for rural or low-income urban communities. Assholes.
There are ways to get more doctors in areas where they are needed. Either by opening up more spots for med school and residency programs, or more funding for education for low-income students, or visas for immigrants who will practice in underserved communities or any other incentives like student loan forgiveness in exchange for service in poor communities.
There are a lot of newly graduated nurses (since the news was claiming there was a shortage) who need their first nursing job as a way to get experience. Community clinics can be a great way for new nurses to start their careers.
valerief
(53,235 posts)Cuz fuckin' America.
beachbum bob
(10,437 posts)you able to purchase private health insurance under ACA guidelines and its not an ACA issue if local doctors and hospitals won't cover policy holders....you need to change carriers....we have the same problem with insurance we pay for thru the state for state workers...some places take it, others don't
Quackers
(2,256 posts)Thank you.
Quackers
(2,256 posts)http://www.politico.com/story/2014/02/barack-obama-obamacare-103589
https://www.washingtonpost.com/blogs/the-fix/post/president-obama-embraces-obamacare-label-but-why/2012/03/25/gIQARJ5qaS_blog.html
http://abcnews.go.com/Politics/video/president-obama-call-obamacare-14309723
https://www.washingtonpost.com/news/post-politics/wp/2014/05/20/obama-in-five-years-it-will-no-longer-be-called-obamacare/
Egnever
(21,506 posts)in New York someone like Care connect.
This story is bullshit.
Quackers
(2,256 posts)Egnever
(21,506 posts)The people buying from the exchange had no options before the ACA. You could not buy a reasonably priced insurance plan before the ACA unless you got it through a job that had group discounts.
Quackers
(2,256 posts)What good is health insurance if you can't afford to pay the deductibles and you're limited to only a few doctors. Now I'm not saying some people haven't benefited from it, but there are a lot of people that are limited on what they can do with it.
Egnever
(21,506 posts)If you want to argue there should never ever be any deductible.. Well I would certainly like that but ACA plans are not unique in having deductibles.
My insurance is not an ACA plan it is fairly decent insurance though a school district and we have deductibles.
It doesn't mean if you go see the doctor for a check up you are paying the whole visit cost until you meet the deductible. Preventative care on ACA plans have no deductible.
Not seeing where the difference is.
CompanyFirstSergeant
(1,558 posts)...it's crap insurance.
Covers nothing.
Jackie Wilson Said
(4,176 posts)That some prick asshole selfish physicians wont take it, I say yank their fucking license.
CompanyFirstSergeant
(1,558 posts)....has a $3,500 deductible.
Jackie Wilson Said
(4,176 posts)sit out the election, let drumpf take over
we deserve it i guess
CompanyFirstSergeant
(1,558 posts)NOTHING is covered until you spend $3,500
That's what I said.... covers nothing.
sit out the election, let drumpf take over <-------- How did he sneak in here?
CompanyFirstSergeant
(1,558 posts)People with very high deductibles are just not going to the doctor.
Jackie Wilson Said
(4,176 posts)When you allow drumpf to take over, health insurance will have no consumer protections as ACA will be withdrawn.
I hope you dont have a single diagnosed condition, because you wont get coverage if you do
savalez
(3,517 posts)And nothing was covered. It's an improvement.
I get my plan from the ACA and it has no deductible and it is way better and less expensive than before the ACA.
Is it free? No. Is it better than before? Yes.
We also have expanded medicare here and a lot of people have free healthcare insurance as a result.
Edit to add that I once did encounter 1 doctor's office that did not take plans purchased off the CoveredCA program. I ultimately had to choose from a list of participating providers. No big deal.
Leontius
(2,270 posts)my new policy is $79 a month with a $200 deductible thru the exchange in my state. I think most of these horror stories about the ACA are bullshit, you just have to do the work to find decent insurance.
xmas74
(29,674 posts)$5 copay. My old one from an employer was $475 a month with $5000 deductible and a $50 copay just at the doctor. My prescription insurance started at $35 for the lowest and went up.
Hoyt
(54,770 posts)deductibles. It gets you a big discount on physician, hospital, and other services. It gets you in the door of providers who won't take uninsured patients. It has issues, but much better than before.
Grins
(7,218 posts)How is that any different from the rest of us?
My Godson just had to get surgery on his shoulder to fix a long-time problem. He's under 26 so he's on his parent's insurance (Thanks, Obama!) plan. They have insurance via their employer - a HUGE corporation.
Cost for his 1-hour operation: $23,000. $19,000 paid by insurance.
They paid the rest as their deductible is $4,000.
former9thward
(32,025 posts)Plenty of Doctors have been refusing Medicare patients for years.
Travis_0004
(5,417 posts)I did some accounting work for a doctor. If we worked for free, the plans didnt pay enough to cover his cost for staff and materials. He would lose money by taking ACA patients.
BeyondGeography
(39,374 posts)And report back. In NYC, you can spend that much just on anesthesia for a colonoscopy.
CompanyFirstSergeant
(1,558 posts)...to hopefully prevent a serious illness....
...is covered.
BeyondGeography
(39,374 posts)Here's a Republican who understands why Obamacare matters:
Egnever
(21,506 posts)Have you ever had insurance before? Cause the nonsense you are spouting right now does not indicate you have.
csziggy
(34,136 posts)When my husband was at the mercy of his employers at to what health insurance they would provide each year our provider went from being in network to not being in network.
Over the fifteen years he worked for the same employer they used 4 or 5 different insurance companies. Our primary care doctor - who we had used for decades - was covered under 2 of them. The other years we had the option of changing doctors or paying out of pocket for a much higher co-pay.
The same thing happened with the employer provided eye care - some years our optometrist was covered, some he was not.
Since we selected providers we liked and we didn't want to change at the whim of the insurance companies, much of the time we paid more but we were lucky enough to afford the extra costs.
Having doctors refuse a particular type of insurance isn't new. The big change is that ACA policies spell out their specifics more completely than many of the old policies so the providers are not able to wiggle out of full coverage.
stopbush
(24,396 posts)How does one know it's Obamacare?
You purchase a policy from Kaiser or UHC or whoever thru Obamacare's exchanges. Nowhere on your health insurance card does it say "Obamacare" or "ACA" or anything that would indicate you got your policy thru Obamacare.
So how in the world would a provider know you got your policy thru Obamacare?
hack89
(39,171 posts)Last edited Wed Aug 9, 2017, 02:13 PM - Edit history (1)
hack89
(39,171 posts)Each plan offered had a unique name.
We have zero clinics in our county that take o-care plans, but will accept insurance purchased outside of the exchange. The nearest clinic accept o-care plans is 75 miles and two counties away.
enlightenment
(8,830 posts)Usually the card you carry indicates what sort of plan you have and those plans are uniquely identified either by name, a number, or some combination.
You - as the plan member - may not be aware of it, but it is identifiable to the people deciding whether or not to take the insurance.
In order to keep my coverage with my doctor I had to buy my plan from the provider DIRECTLY. If I went through the exchange I wouldn't have been covered.
BTW.. the cost to me was identical b/c I wasn't eligible for subsidies; however, WHERE I purchased made all the difference.
PersonNumber503602
(1,134 posts)but I wasn't too sure if it would matter or not. I would rather not do that, because it seems like something that would add to the problem, but I dunno.
basselope
(2,565 posts)In my case what happened was UCLA medical was not covering any Blue Shield of CA policies purchased via the exchange. HOWEVER, when I went to their (blue shield's) website and purchased directly (not using covered california) then it was accepted. There is a slight difference in how they code the coverage and how they pay, which is (what I am told) is the reason they weren't accepting the "exchange" coverage, but the identical thing purchased directly from the company was another story.
The cost was identical. Coverage was identical. One was just through the exchange and one was directly through the company website.
BTW.. IF you do this, don't think that adding a dental plan will take away from the need for your policy to have pediatric dental, even if you are getting dental coverage for your kid. Once we found out we were basically paying twice for dental coverage, we opted against it, because it is basically a rip off anyway when bought individually.
rusty fender
(3,428 posts)When I had Blue Cross/Blue Shield before the ACA, everyone accepted it. Later, when I had Blue Cross/Blue Shield through an ACA exchange, many places would not accept it.
I think that that the bigger insurance companies force medical providers to reject Exchange insurance policies in order to undermine the ACA despite the fact that they are acquiring more customers; what they don't want to accept is sick participants. They want the ACA to collapse so that they can go back to excluding customers with pre-existing conditions.
Egnever
(21,506 posts)And you have the option to look at the listing of doctors that accept it before buying the policy.
ScreamingMeemie
(68,918 posts)The only time I have gotten a "We don't take Obamacare" was at a Walgreens pharmacy.
My reply,"Good? I don't have it. I have insurance through the Affordable Care Act."
ViseGrip
(3,133 posts)My ins. co. sent me to another doctor on the list. I went. He made me pay my 25.00 co pay, when my plan said the well visit did not have a copay.
We left with a prescription for our (my hubby too) blood work. The day before our blood work at the assigned lab, we got a call that the doctor has left the group. I said we are in the middle of a visit, and are to now get the blood work. We were told not to go, it would not be covered! By the time we were able to do this....switch doctors and get in, and try to complete the visit with blood work, the year was over! Not one visit completed, and NO BLOOD WORK FOR THE YEAR!
For this, they were given 1000.00 a mo. subsidy for us by the U.S. government. We got nothing. Just a hammer on the knee reflex test, ahhh....look in the throat, blood pressure, etc. But no blood work. So we have to use the community health centers. Again, thank God for Bernie's foresight into this problem. We now have enough community health centers.
Also know, I tried and tried to talk to ANYONE in my congressional office regarding the doctor shortage, and NO ONE TAKING THESE PLANS. Crickets....and now he's running to be a U.S. senator.
He only does photo ops at veteran memorials.....and they have the VA. Older american's have Medicare. Poor people have Medicaid. Everyone in the large middle? We don't really have shit.
ViseGrip
(3,133 posts)Oh....you go in with an emergency. But none of the doctors on staff that day are in your network, even though your hospital is.
You need a heart bypass and no one can wait! You are knocked out!
The doctor is not in your network? One won't be here for two days??
are you fucking kidding me? they are now trying to tell this story on TV! In the first or second new episode of Frankie and Grace they bring this issue into the light!
randr
(12,412 posts)I am lucky to be on my wife's insurance through her work, the independent contractors who work for me are shit out of luck as I would be if not for my wife.
ErikJ
(6,335 posts)I looked for health insurance as self employed in the 80's and it was such a joke. My dad was an MD so I could always fall back on him to "trade" services with another doctor. But it was getting time to have my own and they were just awful. Luckily I was healthy enough to never need it any. But I did get a skin cancer removed for free just out of a misdiagnosis fluke in '92.
Obamacare did make it better but the 2nd year the cost skyrocketed but I went on the state health plan because I am now taking a few years off and moving with zero income.
tonyt53
(5,737 posts)And that is a fact. They did it to themselves. My son did the same thing, even though I advised him not to.
truebluegreen
(9,033 posts)with or without subsidies. That is at least as much of a fact. Victim blame much?
fbc
(1,668 posts)JCMach1
(27,559 posts)Capitalism doesn't work when 'choice' never really enters the equation.
taught_me_patience
(5,477 posts)20% less revenue can easily amount to 50-60% less pay. Who wants to do the same amount of work for half the pay? My wife is a primary care private practice and takes covered california plans. It's been a big negative impact to our income and we've been talking about her not taking it in the near future.
Omaha Steve
(99,660 posts)Now his legacy is unfunded and falling apart.
He didn't even try on The Employee Free Choice Act!
annabanana
(52,791 posts)In fact, I'm pretty sure. . . .
Omaha Steve
(99,660 posts)And Obama then campaigned FOR Lincoln.
Gene Debs
(582 posts)insurance to tens of millions of uninsured or under-insured Americans..."
Bullshit. The goal of the Affordable Care Act was to provide the illusion of actually doing something about the disastrous health care system in this country while making sure to leave the insurance cartels in control of the whole situation.
LibDemAlways
(15,139 posts)largely crap. Ridiculously high premiums, co-pays, and deductibles and access to limited provider networks.
A hospital stay for a person with the lousy silver plan could easily bankrupt him. A relative's few hours in the ER of the local hospital set him back 5K out of pocket. It's a huge racket, and there's nothing remotely affordable about it.
flamingdem
(39,313 posts)for most people. Talking about individual insurance for one person,
For me it's 100% better than what I had before.
Before Anthem charged me 350 a month and my deductible was 6500.
Now I pay 200 something and have a very low deductible, copay, and low out of pocket.
If you compare to what there was before it is a huge improvement.
LibDemAlways
(15,139 posts)a month. He just missed the cutoff for a subsidy. One medical emergency set him back 5K for the ER, and another $2800 for non covered ambulance services. I know because I helped him pay the bills.
I stand by my remark. Covered California is crap.
flamingdem
(39,313 posts)I stand by my remark for me personally - and for anyone with a pre-existing condition - however I recognize and wrote below that this insurance is very pricey for middle class incomes.
Without a subsidy it's really expensive and on a par with the garbage insurance I had before Obamacare.
Andy823
(11,495 posts)I buy through Washington states Health plan finder site. You fill out the information, our location, and the only plans that come up are for your area. There are numerous insurance company plans to choose from. I checked, on the site, to see if the plan I wanted was accepted by my local doctors, and hospital, it was so I bought it. I have never had one problem getting in to see a doctor.
The only thing I can get out of this is that they might not have been with an issuance company, but with the a Medicaid plan that some doctors won't accept. My daughter is on the Washington state Apple care that is a Medicaid plan, but I made sure to check to see if our local doctors, clinics, and hospitals accepted it and the all did.
silverweb
(16,402 posts)[font color="navy" face="Verdana"]Many other states let the insurance companies write the rules - and the rules are written on a state-by-state basis. That's why we need a federally administered universal, single-payer system.
Egnever
(21,506 posts)You can look up the plans on the exchange yourself and they are exactly the same in new york.
Here is a listing of doctors that take one of the plans available on the exchange within 30 miles of 10001 zip code. https://provider.careconnect.com/provider-result/?category=15&specialty=55&zip=10001&zipcode_radius=30&submit=Go
There are 5 pages of general practitioners.
This article is a con job.
PersonNumber503602
(1,134 posts)It seems pretty common in some places (where I'm from at least) for doctors to not accept insurance that people purchased from the exchanges. The insurance website may list doctors as being in their network, but the doctors are allowed to decide if they are accepting new patients from that plan or not. My doctor right now wouldn't have seen me with my current insurance if I wasn't already a patient of his. I'm currently in the process of trying to find a new job just so I can get into an employer provided plans. It's pretty messed up that people feel the need to do that. If that doesn't pan out, I'm going to do some more research into how it works to private plans outside of the exchanges and if that would help. This isn't a rant against ACA, but just a statement of fact that it needs to be addressed. I fear that if we don't take action to fix it, then that will give the republicans a way in to destroy it completely, and thus put us back to where we were before. Bring back the "good ol' days" of pre-existing conditions denials and making medical care inaccessible to tens of millions.
Thespian2
(2,741 posts)the ACA did very little to deliver adequate health care to the people...Insurance corporations still control the gates of health care...as long as insurance corps and big pharma control the dispensation of health care, Americans will be stuck with a very flawed system...And remember, the wealthy 1% don't give a shit about the health of the 99%...
Victor_c3
(3,557 posts)It didn't go far enough.
Decent quality healthcare should be available to all of our nation's citizens regardless of a means to pay for it. Even if you aren't a citizen and you are contributing to our nation or our economy you should be entitled to it too.
whereisjustice
(2,941 posts)Cryptoad
(8,254 posts)propagating another false attack on Democrats..... obviously the only problems seems to be that there are too many people who do not have enough sense to buy their own health insurance or grasp the fact that ACA is not a insurnace plan. 30 million working poor who for the first time can afford health insurance like it. can it be improved on ,,,, yes. but I know it sure beats the GOP Plan = "Hurry up and die" and the Bull Shit Bern plan that taxes people living in poverty..... no wonder Bern lost to Hillary.
Vinca
(50,278 posts)You get a private insurance card, not an "Obamacare" card. This sounds like BS. None of the doctors I went to when I was on it would have known whether it was "Obamacare" or an insurance card issued by an employer.
alarimer
(16,245 posts)First of all, none of these policies are called "Obamacare". They are Blue Cross, United Health Care, or whatever. And yes, sometimes it might be hard to find doctors because the plans' coverage is so limited, But I'm willing to bet none of them used the word "Obamacare."
flamingdem
(39,313 posts)due to contracts with the insurance companies.
Anyone who tells you it's not an improvement isn't living in reality.
For one thing pre-existing conditions weren't covered before and deductibles were huge for larger premium prices.
I think it's not a good deal for a middle income earner however. Better to be low income for affordability.
PersonNumber503602
(1,134 posts)Whether or not the doctors call it obamacare is irrelevant. Doctors are saying that the exchange plans do not pay out as much, and that is why they limit the number of or refuse certain policies purchased from the exchanges. While I've heard of some right-wing doctors denying exchange/obamacare policies due to political BS, I believe the vast majority do it because the insurance companies are making it less appealing for doctors to accept patients with those plans.
Two obvious partial bandaid solutions might be to ensure insurance companies payout the same regardless of where the plan was purchases, or to force doctors to take new patients regardless of their insurance type. I'm sure most would agree the former is the better of the ideas. Although a single payer or public option is the ultimate solution, I think.
Response to mia (Original post)
Skittles This message was self-deleted by its author.
dilby
(2,273 posts)I know my insurance company does, if I call them up and tell them what I need they give me a list of doctors to choose from in my area. If I just pulled out the phone book and started calling I would probably get the same results as this woman. Sounds like she just wants to complain for no reason and insurance worked like this before, not every doctor took every insurance company.